Bullying: From the workplace to workers compensation systems

We have long argued that injured workers are routinely exposed to bullying tactics by employers and insurers.  In fact, I made it clear in my own impact statement at the recent national workplace bullying inquiry  (There is a case to answer for bullying in the NSW Workers Compensation System).

Being bullied in the workplace is bad enough, however, targets are routinely exposed to further and often more prolonged and damaging bullying once they enter the workers compensation system. This was highlighted in a recent article by Luke Williams (What’s worse than being bullied in your workplace? Making a complaint about it.)

It was interesting to read Evelyn Field’s, a leading expert in workplace bullying,  submission and how she describes the process bullying victims are exposed to in many states, once they make a claim.   Much of what Evelyn highlights relates to not only to victims of workplace bullying, but many injured workers once they enter the adversarial world of workers compensation.  In fact, many injured workers become so traumatised by the system they end up needing psychological and/ or psychiatric assistance  Evelyn writes:

Bullying and its prevalence rates are exacerbated by

• A variety of adversarial practices initiated by employers who deny or delay, Workers Compensation Agencies and their insurance agents
• Poor management (Einarsen , Keynote 2010) as any managers don’t manage their staff effectively and intervene immediately when bullying occurs
• Lack of respect and implementation of Risk Factors ( Worksafe 2007)
•  Human Resources whose loyalty is to management not employees, and who also wait for formal, written complaints instead of intervening immediately, once a target requests help
• Weak unions, who promise help but can’t actually do anything. Thus targets wait longer until they are injured further
• Dodgy practices by insurance providers, which injure targets further, creating more victims of workplace bullying for example -eg:
• The majority of bullying claims appear to be first rejected by the insurer/employer
• Only a few targets have the opportunity and support to follow through and fight for their worker’s compensation entitlements. This can take twelve months plus. They get no medical and like expenses in the mean time
• It seems to me that insurance employees and employers are actually making decisions on whether or not a victim has been bullied/injured at work and what those injuries are. This should be in the domain and responsibility of medical /psychiatric/psychological professionals. The need for legal evidence, despite the fact that most witnesses are too scared to testify, is an indication that medical injuries are currently assessed by legal methods not medical and psychological diagnostic procedures
• Insurance case managers change all the time, most appear to have little understanding of their psychological injury and that their own behaviours and attitude can be experienced by the target as a continuation of the bullying. Some become angry when their practices are questioned and retaliate later
• Victims requiring extra assistance, eg housekeeping, gardening, physical exercise, dietary help, are forced to go through very stressful conciliation processes each time they need something. Most give up
• Case managers and their managers who send out confidential information about clients to Independent Medical Examiners, who then utilise these other medical reports to base their report on. Oddly enough, they usually forget to send on my psychological reports and anything else favouring the client!
• They send unnecessary medical confidential information to non-medical personnel, eg rehabilitation /vocational providers
• External rehabilitation consultants who listen to the employer first, not the employee, eg “We are nice, it is the employee who is difficult.” (Email from Ass.Prof in medical research, dated June 2011)
• The ability by their doctors and health professionals to identify and manage their symptoms effectively, (which is currently limited) and provide constructive feedback to the target’s employer. Most medical professionals do not have the confidence, training or know how to provide feedback to the employer/insurance company/ rehabilitation provider in order that they can get their client back to work as soon as possible
• The medical opinions of the target’s general practitioner, who may have known them for years, is generally disregarded, eg Dr Erica Wils, a senior doctor, (Airlie Women’s Clinic, Prahran,) is devalued in favour of an “Expert” who sees the terrified victim for a maximum of forty minutes and often less.
• Generally, employers are not interested in how medical/psychological professionals can contribute towards resolving the dispute more effectively and speedily to help the injured employee back to work. Thus, if the psychologist or GP wants to recommend that the risk factors for bullying be addressed in the workplace in order that their client can go back to work as soon as possible, most employers are not interested. Thus their client, being unsafe, remains stuck at home, slowly deteriorating.
• Currently, there is no counselling via SKYPE , Facetime , which is paid by Managed Health Care Plan, Medicare, or by Workcover, thus country based victims have less access to skilled counselling as most psychologists work in the major cities . If they see a local therapist, some have less expertise and confidentiality in a small town makes recovery harder. One country client went to a psychologist and saw her bully sitting in the waiting room!
• Those companies who “pretend to care” by their stated policies and build up expectations of support when bullying is reported but who in fact, basically retaliate or undermine, thereby injuring targets further. (Refer Dr Pat Ferris, Canada)
• Thus, it appears that an employee is actually far better working for a rough and tough company who doesn’t care about employee welfare, and who make this fact known and who don’t make false promises. Then employees are compelled to listen to their gut instincts and take action to protect themselves.
• It is the duty of the Board of Directors, their CEO and their managers, to implement good risk management processes and deal with any bullying in a respectful, collaborative, manner. Currently, most complaints of bullying at work are dealt with in an adversarial manner, thus the poor target (or bully) can be  further attacked from their line manager, colleagues, Human resources, insurance provider, lawyer for many, many years.
• The list of health and legal professionals who have deserted victims over the years is also long, including fellow workers who turn against them, unions who give up, lawyers who delay or charge more than targets can afford, general practitioners who don’t understand and lack patience with their continual obsessing (about what occurred in their search to explain why their life and health feel apart at work) and why they lost a special job.
• It also includes psychologists, some of whom feel forced by Worksafe to follow the fashion of “ one size fits all” approach to treatment, for example, Cognitive Behaviour Therapy, which although useful for some employees who have just been bullied and can still function, has no evidence-based research that it will assist long term victims who will never work again, according to current international research.
• Many professionals also fear diagnosing a post-traumatic stress disorder, when clinically appropriate, and follow local psychiatric fashion by diagnosing an adjustment disorder. This is regarded by victims as blaming them further, as it is seen as blaming the target, thereby undermining any possible forms of validation, minimalising their injuries and reducing any potential compensation payouts.
• It also includes psychiatrists who mean well, but lack any knowledge or training. There was only one Australian psychiatrist at the recent conference in Copenhagen, (2012) but he is retiring this year. I can’t recall any other Australian psychiatrists at any previous international conferences! Many who do psychiatric assessments for medico-legal purposes were trained in the old former psychiatric institutions to treat psychiatric disorders, like schizophrenia, Bi-polar disorder, often using Freudian therapies and drugs.
• Most medico-legal psychiatrists and psychologists do not understand that victims of workplace bullying, unlike victims of other trauma, will obsess for years, they become hyper vigilant, although their bullying experiences do not explain the their high degree of paranoid thinking, behaviours or symptoms.
• They are unaware of all their patient’s physical, cognitive and psychological symptoms, the changes to their personality, family and social life. They do not understand the role of toxic work systems in injuring an employee’s health, wellbeing, working ability and life outside work.
• Nor do they understand the impact of bystander distress, reduced productivity, fraud, unethical behaviours etc. In other words, they do not understand that bullying is a sign of a poorly functioning work environment, representing many different areas of malfunction. The target they are attacking is only one piece of the poorly functioning work system.
• They do not realise that every victim only wants validation of their bullying experiences, (as they don’t believe that they deserved the bullying behaviours) safety at work, and if they are injured and forced to leave work, they want income to survive and the appropriate medical and psychological treatment.
• Some insurance companies bully psychiatrists to change their reports, and I have seen the evidence where one psychiatrist was asked almost three times within a week to change his diagnosis and prognosis!

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